There has been an increase in both paid and unpaid overtime since 2012 – overall 72% worked additional hours in 2016.
Photograph: Alamy

This past year has sent shockwaves through an already challenging working environment in the NHS. From the withdrawal of nursing bursaries and junior doctors’ strikes to the uncertain impact of Brexit on 58,000 EU nationals currently working in the health service, workforce pressures continued to build for an already overstretched service.

So what do the findings of the latest NHS staff survey, released on Tuesday, tell us about how staff are coping? Covering 316 participating NHS organisations, the survey is the biggest in the world, capturing the experiences of more than 423,000 healthcare professionals across the country.

The good news is that despite the tremendous pressures the NHS faces, nearly three quarters of staff remain enthusiastic about their job, while 70% said they would be happy with the standard of care provided by their organisation if a friend or relative needed treatment. The proportion of staff who reported feeling unwell due to work-related stress is at its lowest since 2012, down to 37%.

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Responses addressing another key aspect of staff motivation – feeling empowered to contribute suggestions for improving work practices – also signalled positives. More than 70% of staff said that there are frequent opportunities to show initiative in their role, and 75% reported making suggestions to improve the work of their team or department. The survey did indicate room for improvement, however. Only a small majority of staff (56%) stated that these suggestions were actually acted upon – staff feedback does not appear to always translate into tangible change.

As is to be expected in such a pressured working environment, the survey does highlight some challenges for the NHS. More than half of staff (56%) report having attended work in the last three months despite feeling unwell, due to pressure from either their manager, colleagues or themselves. This is, however, a significant improvement since 2012, when 64% attended work despite illness. Most of this pressure comes from staff themselves (92%), rather than from managers (26%) or other colleagues (20%).

Generally, staff report feeling that managers are invested in their health and wellbeing. Most say that their immediate manager takes an interest in their health and wellbeing (67%) and that their organisation more broadly takes positive action on the health and wellbeing of staff (90%). These figures are on a par with those from last year’s survey and describe a workforce committed to working together and supporting one another to deliver high quality care – one that struggles more with heavy workloads and external pressures.

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A key aspect of wellbeing is maintaining a healthy work-life balance and this is another area that contains some worrying figures. Staff report being satisfied with the opportunities to work flexibly – but 59% are, on average, working additional unpaid hours each week. Overall, the proportion of staff working additional hours is 72%, indicating that not enough has been done to alleviate workloads in light of similar results in recent years. The steady increase in both paid and unpaid overtime since 2012 is concerning as research repeatedly suggests that relying on tired and over-worked staff can lead to poorer standards of care.

The results of the 2016 staff survey suggest NHS staff are showing remarkable resilience despite the huge pressures that have been placed on the system. However, with external pressures such as Brexit likely to exacerbate existing problems in future years, a concerted effort is required from the government and NHS England to ensure that the positives to be found in staff motivation and engagement this year are not lost. NHS staff are subject to immense pressures that are unlikely to ease without significant support.

Rory Corbett is a senior research associate at Picker, a charity that co-ordinates the NHS staff survey on behalf of NHS England